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How Can You Start to Treat Diastasis Recti Yourself?

Visceral Mobilization

Diastasis Recti might seem complicated and overwhelming to treat, but there are some simple things you can do to start treating it yourself! Start by following our tips below:

Relax your Belly Muscles and Breathe!

The way you breathe can influence the daily stress that you put on your abdominal muscles.  Many of us breathe through our chests all day long and hold our stomachs tight, putting constant stress on the abdominal wall and increased tightness in the abdominal muscles and the fascia (coverings around the muscles and organs).  No muscle can tolerate long-term strain all day long, so give your abdominals a break and let them relax!  Yes, you read that correctly.  Let your belly relax and stop sucking it in!  Once you relax the belly muscles, try some diaphragmatic breathing. This type of breathing will actually help the belly muscles work properly and allow you to strengthen them in a proper, more functional way when you hold them in.  

How to Perform Diaphragmatic Breathing

Diaphragmatic breathing utilizes the diaphragm to help us breathe in a way that creates positive pressure in the belly and reduces irregular tension on the abdominal wall.  It has an overall, whole body effect for muscle and nerve relaxation.  To perform diaphragmatic breathing, lie on your back in a relaxed position and place your hands on your lower belly.  Relax your belly muscles.  Exhale and gently let the air out of your lungs.  When you take a breath in, allow the air to go into your belly instead of your chest.  Don’t force the belly out on your inhale but think about the air moving into your belly and your low back gently.  As you exhale, the belly will fall back down towards your spine and the floor.  This is diaphragmatic breathing.  Rebalance physical therapists can assess your current breathing pattern and help you learn how to correct it as needed.  

Don’t Hold Your Breath.This point goes along with our above tip about diaphragmatic breathing. If you are holding your breath, chances are you are also tensing your abdominal muscles.  If you find yourself holding your breath, take 5 diaphragmatic breaths so you can alleviate some of the tension in your belly muscles.  

Avoid Straining in the Bathroom. Straining to move your bowels or urinate increases the pressure on your abdominal wall.  The first step to manage straining is to eat a high fiber diet and stay hydrated.  This increases GI motility (the movement of food through your digestive system), ease of evacuation, and reduces straining that places stress on the abdominal and pelvic muscles. 

Remember your Posture.Good alignment and posture is essential to the abdomen working correctly.  Slouching in standing and/or sitting increased pressure on the abdominal wall and it makes it more difficult for the abdominal muscles to work correctly.  A physical therapist can give you individualized recommendations to improve your alignment with daily activity.  

Avoid Excessive Sitting. The fact is that we were not meant to sit for many hours of the day.  Sitting places stress on the belly.  It also places stress on the back and pelvic bones which can cause the back and pelvic muscles to tighten. The average American sits for 15 hours/day.  Image how this pressure can add up and take its toll on your belly.  Try an alternative to sitting and make your own standing desk.  Set up a box or crate at your desk or counter to give yourself a variety of positions to get your work done during the day.  You don’t need to stand all the time but varying your sitting and standing positions during the work day can dramatically reduce the overall cumulative time that you spend sitting.  A physical therapist can help you determine the most ergonomic standing desk options if you have questions.

Walk. Did you know that walking can improve your posture and take pressure off the abdominal muscles? It also gets you breathing!

Lay down and Relax.To further cut down on sitting time, lay down on your couch, bed, or floor to read. watch TV or relax.  This gives your abdominal cavity a break from the increased pressure placed on it in sitting.  It can also relax and lengthen tight muscles and fascia in the abdominal cavity that contribute to abdominal wall tension.  

Examine Your Exercise Program. Crunches and oblique exercises can place increased pressure in the abdominal cavity and the pelvic floor.  Other exercises, such as leg lowers, can increase strain on the abdominal wall if you don’t have strong enough abdominals to support the exercise. A physical therapist can evaluate your core exercises and exercise program to help identify if any of the exercises could be contributing to your diastasis. The physical therapist can work with you to modify your exercise program to help your diastasis heal but keep you healthy and active at the same time. If you aren’t currently active and are afraid to start an exercise program because you think you have a diastasis, a physical therapist can also help create a routine that will help you avoid pain and get active.  

Specific Exercise to Avoid if you have a DR:

  • abdominal sit-ups
  • crunches
  • oblique curls
  • double leg lifts
  • upper body twisting exercises
  • exercises that include backbends over an exercise ball
  • yoga postures that stretch the abs, such as “cow” pose and “up-dog” pose
  • pilates exercises that require the head to be lifted off the floor
  • lifting and carrying heavy objects
  • intense coughing without abdominal support

Basically, you need to avoid any exercise that causes your abdominal wall to bulge out upon exertion. Once the DR is closed, you can gradually add these activities back in.  You can also work with a physical therapist to consider better alternatives.  

 Seek Out a Physical Therapist Who Treats Diastasis Recti.  There are many ways to address DR but the suggestions above are only a sampling of strategies that skilled pelvic floor therapists use to treat DR. Diastasis Recti treatment is specific to each person.  If you suspect that you have a diastasis, consider a comprehensive physical therapy evaluation.  The physical therapists at Rebalance have many years of experience treating diastasis and can help you to determine the extent of your DR and how to best manage it! Contact us today to schedule your evaluation. 

Written by Stephanie Muntzer, MPT, CPI, SFMA, FMSc, PTYc

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